David Dunkelman chose the right time to devote his career to rethinking care for the elderly.
It was 1984, and nursing homes were dominated by hospital-like facilities built for efficiency and woefully inadequate to the needs of an aging population.
He had been named director of the Rosa Coplon Jewish Home & Infirmary, then a nursing home on Symphony Circle, and board leaders asked him for an assessment.
“I told them we had the wrong building in the wrong location with the wrong people, the wrong programs and the wrong staff. Otherwise, things were great,” recalled Dunkelman, who recently announced his retirement as chief executive of Weinberg Campus. “Then they asked me what things should look like.”
That is how Weinberg came to be. When it opened in 1993 in Getzville after years of planning, there was nothing like it in Western New York or much of the nation.
Weinberg offered different levels of services, from adult day care and independent apartments to assisted living and skilled nursing. It moved away from an institutional feel in favor of a more decentralized, neighborhood design. It accommodated low-income seniors, as well as those with memory loss and the mentally disabled.
Most of all, Weinberg did all this and more in one place.
Two-plus decades later, the sprawling 100-acre campus still exemplifies many of the most progressive ideas in long-term care.
“The view of aging used to be that it was about inevitable decline, that there was nothing you could do but make people comfortable,” said Dunkelman. “Weinberg grew out of a growing acknowledgement that we could control a significant portion of how we age. There was an explosion of interventions to help people with the physical, cognitive and emotional aspects.”
Now, 68, Dunkelman got into long-term care in a roundabout way.
He worked in his father’s import-export apparel business in Cincinnati, but it wasn’t for him. One day he wrote down what he sought in a career – working with people, complexity and community involvement headed the list. He did some research, settling on a field that satisfied his idealism and, with a record of poor quality, screamed for reform. He wanted to care for old people.
Dunkelman earned a master’s degree at the University of North Texas, studying under a leading advocate for improving services to the elderly, and landed in Buffalo.
“Aging just seemed like the next wave,” he recalled.
It remains so. By 2050, more than 20 percent of the U.S. population will be 65 or older, up from 13 percent in 2010. Millions will need assistance, yet Dunkelman says the nation lacks a strategy to finance and provide it.
“There is no public leadership around long-term care. We are blind to the scale and size of what is happening,” he said.
From his start at Rosa Coplon, Dunkelman earned a reputation as an innovator.
“David marched to his own drummer,” said Ann Monroe, president of the Health Foundation for Western & Central New York. “By that, I mean he always looked at the horizon and saw what was coming.”
“He was absolutely correct in what lay ahead. The future was in creating a continuum of care, integrating different levels with different kinds of support,” said Peter Fleischmann, chief executive of the Foundation for Jewish Philanthropies, which manages the campus’ reserves and endowed assets.
It wasn’t just a matter of reimagining the nursing home. He and others point to Weinberg’s PACE program, the first managed long-term care program in the region, which allows residents to remain in their homes and receive the services available in nursing homes. They also cite Weinberg’s partnering with other organizations to open a Town Square for Aging in Amherst this year. Dunkelman describes it as a one-of-kind “gerontological mall” that will include a food pantry along with businesses and services.
“There isn’t enough money to keep putting up buildings for the elderly. The answer is integrating as much as we can in one place that anyone in the community can use,” he said.
Weinberg is not perfect. It lost money in 2013 and 2014, and is expected to lose money in 2015, an official recently told The News in announcing plans to explore alternative management options for the senior-living community. The potential change reflects the complexities of reimbursement, technological demands and need for capital that are driving affiliations throughout the industry.
“The business has become almost incomprehensible. I was not a good manager,” Dunkelman said.
Fleischmann says Dunkelman is too hard on himself.
“We need to be open to different ways of doing business,” he said. “David was more comfortable building, and the reality is that he put together an amazing institution.”